Agnes House 81

Updated 10 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

Agnes House 81 is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection.

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and one relative about their experience of the care provided. We also observed the way support was provided to people. We spoke with two support staff, one senior and the registered manager.

We reviewed a range of documents and records including the care records for one person and their medicine records, three staff files and training records. We also looked at records that related to the management and quality assurance of the service.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We requested training information, audits and quality assurance records.

Updated 10 January 2020

About the service

Agnes House 81 is residential care home providing personal care for up to two people with a Learning disability. The service was supporting one person at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Systems to monitor the way medicines were administered required improvement to ensure issues could be identified and addressed in a timely manner. People did receive their medicines when they needed them.

The environment was homely in design and met people’s needs, but renewal work and repairs were not completed in a timely manner. Quality assurance systems were not robust enough to identify shortfalls and drive improvement. Records to support the oversight of the service were not readily available during the inspection visit for us to review.

People were supported by sufficient numbers of staff who knew them well and had an awareness of how to escalate any concerns about people’s safety. Staff had received the training they required for their role but were awaiting refresher training to update their skills and knowledge.

Staff wore gloves and aprons to ensure they protected people from cross infection. Some systems were in place to enable the staff and the registered manager to learn lessons from any incident and accidents that had occurred in the service.

Staff sought peoples consent before providing support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People accessed healthcare services to ensure they received ongoing healthcare support. People were given choices and were involved to make daily decisions around their care.

People had meaningful activities to occupy them on a daily basis. People had care plans in place which provided staff with information about their needs and preferences and how they would like these to be met. However, support plans were not updated in a timely manner when people’s needs changed. A complaints procedure was in place and people and their relatives knew how to raise concerns.

Rating at last inspection and update.

The last rating for this service was requires improvement (published 5 December 2018).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a continued breach in relation to the governance systems and quality assurance monitoring of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will also meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk